Provider Demographics
NPI:1366591653
Name:SPILLANE-GRIECO, EILEEN (PHD,DSW)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:
Last Name:SPILLANE-GRIECO
Suffix:
Gender:F
Credentials:PHD,DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 ALGONKIN TRL
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-2051
Mailing Address - Country:US
Mailing Address - Phone:732-449-0126
Mailing Address - Fax:732-449-0126
Practice Address - Street 1:215 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-1360
Practice Address - Country:US
Practice Address - Phone:732-449-0126
Practice Address - Fax:732-449-0126
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003880001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical